Pappas Dimitrios A, Giles Jon T
Division of Rheumatology, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Curr Opin Rheumatol. 2008 Jul;20(4):450-6. doi: 10.1097/BOR.0b013e3282fcc345.
Patients with rheumatoid arthritis and other inflammatory arthritides treated with tumor necrosis factor inhibitors frequently undergo orthopedic procedures. These patients may be at risk for serious postoperative infections as antitumor necrosis factor agents may be associated with impaired immunity against usual and opportunistic pathogens.
Information regarding the influence of tumor necrosis factor inhibitors on the risk for postoperative orthopedic complications is limited, contradictory and solely based on retrospective studies. Basic science derived data seem to only add to the confusion.
The practitioner is at a loss whenever a decision regarding the perioperative handling of antitumor necrosis factor agents has to be made. An attempt to combine, reconcile, and expand the knowledge available in the current literature will be made.
接受肿瘤坏死因子抑制剂治疗的类风湿关节炎及其他炎性关节炎患者常需接受骨科手术。这些患者术后可能面临严重感染风险，因为抗肿瘤坏死因子药物可能会削弱对常见病原体和机会性病原体的免疫力。
关于肿瘤坏死因子抑制剂对术后骨科并发症风险影响的信息有限、相互矛盾，且仅基于回顾性研究。基础科学得出的数据似乎只会增加混乱。
每当需要就围手术期抗肿瘤坏死因子药物的处理做出决策时，医生都会感到困惑。本文将尝试整合、梳理并扩充当前文献中的现有知识。
